Many teen girls seeking care in the ED at high risk for pregnancy

Sexually active adolescents seeking care in the emergency department have a high risk for pregnancy, and the emergency department may provide a feasible environment to offer contraception counseling, according to a study published online June 28 in JAMA Network Open.

Hannah Canter, M.D., from Oregon Health and Science University in Portland, and colleagues assessed the use of contraception, the pregnancy risk index (PRI), and emergency contraception (EC) prescriptions among female adolescents presenting to the emergency department for care. The analysis included 1,063 sexually active participants seen at six urban, pediatric tertiary care emergency departments.

The researchers found that 71.1% of participants reported contraception use during their last sexual encounter. The least used method was long-acting reversible contraception use (LARC; 15.4%), while 28.9% reported no contraception use. Insurance and race and ethnicity were associated with overall contraception use and LARC use specifically. The PRI estimated an expected eight pregnancies per 100 female individuals per year. While 10.2% of participants were eligible for EC, EC was ordered for only 5.6% of those eligible.

"In conclusion, expanding contraceptive services, including EC, in pediatric emergency departments may improve access to care and decrease the risk of unintended pregnancy for adolescents," the authors write. "Future studies should focus on strategies to improve EC administration in the emergency department and explore provision of additional contraception care in the emergency department."

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